The report cites the “single, integrated eligibility system [Kentucky] built for Kynect and Medicaid” as one of the most pivotal components to its success.

The foundation also concludes that the state’s leadership and collaboration, outreach and marketing efforts, and diverse network of enrollment assistance were also contributing factors to its success.

In a statement from Saving KY Healthcare, former Gov. Steve Beshear — a principal with the nonprofit — said Kynect and Medicaid expansion had a big impact.

“The successful rollout was largely due to thorough coordination by officials throughout the state, and a comprehensive effort to ensure that all aspects of Kynect and the expansion were ready to launch on day one,” he said.

Kentucky’s uninsured rate has experienced one of the sharpest declines in the country. In 2013, the uninsured rate was 16 percent in the state; in 2014 it was 8 percent, according to KFF.

Enrollment in Medicaid grew by 94 percent between July 2013 and December 2015, according to the foundation. And about 94,000 people are enrolled in a qualified health plan through Kynect, according to the report.

The foundation’s analysis also examined the ACA implementation’s economic impact on the state. It found a net positive fiscal impact from Medicaid expansion of $919.1 million from 2014 to 2021 compared with what the state would have spent had it not expanded the service.

The state’s health care system and overall economy gained $1.16 billion due to new federal payments to health care providers for Medicaid expansion enrollees in 2014, according to the analysis.

The foundation also looked at the future of ACA in Kentucky under Gov. Matt Bevin.

WFPL previously reported that Bevin plans to dismantle Kynect and transfer users to the federally run healthcare.gov exchange. He also has plans to apply for 1115 and 1332 waivers to customize the state’s Medicaid expansion program.

Jessica Ditto, spokeswoman for Bevin, said in an email that Kentucky’s current health care system is unsustainable. She said the state is spending nearly $4 billion on Medicaid this biennium, and that is expected to grow by $380 billion in the current budget.

“We are working to transform our health care system into one that is sustainable, encourages personal responsibility and provides quality affordable health services for Kentuckians,” she said.

The analysis from Kaiser said timely and effective data transfers between Benefind and healthcare.gov would be key for providing a seamless enrollment experience and preventing delays in eligibility determinations and gaps in coverage.

The report also says these changes could affect whether insurers participate in the market.

Ditto said the administration’s focus is on growing jobs and the economic opportunity so that more people enroll in private insurance.